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Dr. Bob is Robert Hsiung, MD,
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Posted by katia on September 3, 2003, at 18:17:55
In reply to Re: A glass of dopamine » katia, posted by BarbaraCat on September 3, 2003, at 15:30:05
God, what you've described as mixed sounds exactly like what I've been calling my clinical/suicidal depressions.
I think that I've been chronically clinically depressed and have been calling that wrongly "dysthymia". I know that what i've experienced for the majority of my life is more mod/severe depression.
I have been thinking of my mixed states as when I'm racing around a mile a minute, starting things (projects,classes,etc.) interspersed with underlying and any minute irritability, wired and tired, high energy. Maybe that's the hypo/manic side?
geez, it's hard to figure out especially when you've lived behind the veil of your mind for years on end denying it from yourself and feeling like everyone else felt this way too.
Ummmmmm. I feel ok today. I upped the Dp.to 625 mg. yesterday. Took 125mg in the day and felt exhausted; couldn't go to yoga;couldn't write my 12 pages that are due tomorrow. Took 500mg at night and I felt like I woke up. It took til after 2 to fall asleep. I'm so wierd!!!!
Today, I take 750 at night.I just got back from that metabolic testing. God I was hungry!! Finally at 3:30 I could eat since midnight the night before. I'm a "fast oxidizer" and have a diet regime and lots of prohibotic supplements to take. Appart. my digestive tract is all out of whack. I did a meridan/acupressure testing among other things - the whole thing took three hours. my lungs are good. My heart is great! it's just everything underneath.
The two supplements that gave me that cause a bit of concern are: fish oil and L-Carnitine. The rest just support digestion; but these could affect my mood and I"m wondering if I should be taking/putting other variables into the pot at this point? I'll ask my pdoc. I felt a little silly when I realized that I should've asked him first to see if it would screw things up finding the right med.
Wadda you think?
I've finally met someone more prolific than me Barbara! p.s. that metabolic doc told me only one glass of dopamine at a time (per day and no more than five per week)! that'll be an interesting challenge.
Katia> **Yeah, depression is a totally inept word to call those two very differing states. I get both but the worst by far is the despair/crying and that's my mixed states state.
>
> > Also, the 5HTP helps with depression (or supposedly does) like an AD right? i shouldn't be on ADs anyway so I understand if it didn't help me at the time.
>
> **Well, the whole SSRI serotonin uptake theory is up for debate right now. No doubt they help with some kinds of depression but the mechanism as to how and why isn't looking like it's the uptake at the synaptic cleft theory that's the cause. So, yes, 5-HTP increases serotonin but low serotonin may not be the problem. The disconnect may be occurring further downline in the second messenger system. Detractors of SSRI's helping depression (not the fanatics, just those who say they're not very effective long term) make alot of sense, but I sure couldn't quote them at the moment. I only know they made me very very suicidally depressed.
> >
> > I'm trying to figure out what sort of state I've been experiencing the past week - mixed or depressed? It's important to know. Altho' i have no sexual partner, my sex drive is definitely not low. is this an indicator?
>
> **Dopamine definitely perks up the sex drive. Serotonin dampens it, SSRI's kill it. But beats me what that means about the spectrum. But using sex drive is an interesting idea to ponder. When I'm high on alcohol or pain killers which rev the dopamine, I want to screw like a bunny. If I'm mildly hypomanic, I also get rather randy. If I'm full blown manic, sex is the last thing on my mind because I'm in communion with God, the Universe and Everything and sex seems so ho-hum. If I'm apathetically anhedonic sex is also the last thing on my mind cause I feel ugly fat and soooo weary. I dunno. There do seem to be indicators. All this probably has nothing to do with any chemical as we currently know them anyway.
>
> All in all, I can usually tell where I am on the spectrum by my sleep. Depression, I sleep alot, all day if I could. I have enough presence to be totally cynical and disgusted with the human race. Mixed, I wail and pace and am tortured and wrung out and burnt out. I'm super sensitized to pain and doom everywhere, and even though I still don't particularly like most humans, I despair for us all. Mainly I despair for the animals, trees, non-human things. When I can bear to pick up a newspaper, comics are all I can stand, and even they make me weep with their sheer crudeness. I weep in stores. I worry incessantly. Very little sleep, even with way too many sleeping pills. Of couse, this is a definitely recognizable mixed state for me. There are gradients. But again, the sleep thing is usually the tipoff. Also, depression is more turned in, like 'my life sucks, nothing is working, nobody likes me, why is it this way, it will never be any different'. It's mostly about me and my life being horrible, there's rarely enough energy to dredge up the anguish that's the hallmark of mixed states for me. Mixed states is more existentially awful, the horror of existence, the insane God, shattering. When I think of me and my life during mixed states it's in utter despair and hopelessness which is claustrophonic, panicked and livid with pain instead of the sinking murk of a good old depression.
>
>
Posted by BarbaraCat on September 3, 2003, at 23:29:10
In reply to Re: A glass of dopamine » BarbaraCat, posted by katia on September 3, 2003, at 18:17:55
> God, what you've described as mixed sounds exactly like what I've been calling my clinical/suicidal depressions.
**That's what I used to think. Couldn't decide if it was agitated depression, general anxiety with depression or what. Mixed states is such a new term but what distinguishes it from anxious depression is the psychotic quality of it. It's much more than severe depression because of the explosive wailing and gnashing of teeth aspect and the total out of control nightmare quality. Alot of people are calling their symptoms 'mixed states' lately because the term has made it into the common lexicon, but anxious or irritable depression without that psychotic bipolar-I nightmare flavor ain't mixed states (I'm convinced it's a BP-I thing rather than BP-II because of it's halucinatory hellishness).
Now I could be totally wrong but that horror thing is what I've come to believe is mixed states from the hours and hours of research I've put into it. There really isn't a whole lot out there on it that's consistent. Maybe what you thought, suicidal major depression, is closer to home and what that 'other' thing is - who knows. It sure is different from anything I've ever read about depression. That panicked screaming of the universe is not typical. The closest is Kay Redfield Jamison's description of her awful despairing psychotic depressions as part of her BP-I cycles. She also spoke of hearing 'lettuce screaming' on her salad plate. First time I'd ever heard of someone else experiencing that.
I sometimes think it's schizophrenia, but schiz is not a cyclical thing and it's not so wrought with the awareness of despair.
> I think that I've been chronically clinically depressed and have been calling that wrongly "dysthymia". I know that what i've experienced for the majority of my life is more mod/severe depression.
**Me too. I'd have a mixed whopper every few years or so, but typically mainly mod/severe depression a few times a year, with chunks of time interspered where I felt fine and normal. It was only the last 5-6 or so years that mixed states were becoming way too frequent and overlayed with fibromyalgia symptoms (which I personally think was my body's way of saying "Uncle, had enough, do something!").
> I have been thinking of my mixed states as when I'm racing around a mile a minute, starting things (projects,classes,etc.) interspersed with underlying and any minute irritability, wired and tired, high energy. Maybe that's the hypo/manic side?
**Yes, that's hypomania. Sometimes it's fun, sometimes its disorganized, sometimes it's irritibility but it's always light years from the severity of mixed states. Mixed states can also be murderous rage and uncontrollable violence, as my father used to get.
> My digestive tract is all out of whack.
**Yeah, mine too. It's getting better with the priobiotics. Finally being able to take a crap has become an event to celebrate.
> The two supplements that gave me that cause a bit of concern are: fish oil and L-Carnitine.
**Fish oil is good, especially for bipolars. Most pdocs agree with this, but you've got a good point about putting too many variables in at once. Same with L-Carnitine, even though it's good to normalize blood sugar. Probably good to do it but maybe wait until the Dep is stable?
> I've finally met someone more prolific than me Barbara! p.s. that metabolic doc told me only one glass of dopamine at a time (per day and no more than five per week)! that'll be an interesting challenge.
**I'm going cold turkey on that glass of dopamine (I'll never think of it by any other name again!), at least for a while. I got a book today written by a pdoc about what's going on from a neurological and emotional level around craving and addictions. I'll let you know if it's any good. I'm hoping to heal my burnt out lightbulbs in the brain and give it a break from all that sugar and booze. But oooo! wah!!! No fair!!!
- Barbara
>
> > **Yeah, depression is a totally inept word to call those two very differing states. I get both but the worst by far is the despair/crying and that's my mixed states state.
> >
> > > Also, the 5HTP helps with depression (or supposedly does) like an AD right? i shouldn't be on ADs anyway so I understand if it didn't help me at the time.
> >
> > **Well, the whole SSRI serotonin uptake theory is up for debate right now. No doubt they help with some kinds of depression but the mechanism as to how and why isn't looking like it's the uptake at the synaptic cleft theory that's the cause. So, yes, 5-HTP increases serotonin but low serotonin may not be the problem. The disconnect may be occurring further downline in the second messenger system. Detractors of SSRI's helping depression (not the fanatics, just those who say they're not very effective long term) make alot of sense, but I sure couldn't quote them at the moment. I only know they made me very very suicidally depressed.
> > >
> > > I'm trying to figure out what sort of state I've been experiencing the past week - mixed or depressed? It's important to know. Altho' i have no sexual partner, my sex drive is definitely not low. is this an indicator?
> >
> > **Dopamine definitely perks up the sex drive. Serotonin dampens it, SSRI's kill it. But beats me what that means about the spectrum. But using sex drive is an interesting idea to ponder. When I'm high on alcohol or pain killers which rev the dopamine, I want to screw like a bunny. If I'm mildly hypomanic, I also get rather randy. If I'm full blown manic, sex is the last thing on my mind because I'm in communion with God, the Universe and Everything and sex seems so ho-hum. If I'm apathetically anhedonic sex is also the last thing on my mind cause I feel ugly fat and soooo weary. I dunno. There do seem to be indicators. All this probably has nothing to do with any chemical as we currently know them anyway.
> >
> > All in all, I can usually tell where I am on the spectrum by my sleep. Depression, I sleep alot, all day if I could. I have enough presence to be totally cynical and disgusted with the human race. Mixed, I wail and pace and am tortured and wrung out and burnt out. I'm super sensitized to pain and doom everywhere, and even though I still don't particularly like most humans, I despair for us all. Mainly I despair for the animals, trees, non-human things. When I can bear to pick up a newspaper, comics are all I can stand, and even they make me weep with their sheer crudeness. I weep in stores. I worry incessantly. Very little sleep, even with way too many sleeping pills. Of couse, this is a definitely recognizable mixed state for me. There are gradients. But again, the sleep thing is usually the tipoff. Also, depression is more turned in, like 'my life sucks, nothing is working, nobody likes me, why is it this way, it will never be any different'. It's mostly about me and my life being horrible, there's rarely enough energy to dredge up the anguish that's the hallmark of mixed states for me. Mixed states is more existentially awful, the horror of existence, the insane God, shattering. When I think of me and my life during mixed states it's in utter despair and hopelessness which is claustrophonic, panicked and livid with pain instead of the sinking murk of a good old depression.
> >
> >
>
>
Posted by katia on September 4, 2003, at 0:42:11
In reply to Re: A glass of dopamine » katia, posted by BarbaraCat on September 3, 2003, at 23:29:10
>>It's much more than severe depression because of the explosive wailing and gnashing of teeth aspect and the total out of control nightmare quality.
Well what I've experienced has been much more energetic than most "depressives" have experienced with their depression. In fact a friend of mine who let me stay in her place last summer when I got back from Scotland was frightened at the intensity of my energy and anger. and she even has had a life time of depression.
I feel out of control and lash out physically if there is a boyfriend in sight. I throw things out of utter anguish and could ruin the most precious painting or family hierloom and wouldn't have control over my actions. I feel like I am in a tornado of hell - lots of energy and it's tormenting and I'm just lashing out left and right exhausted, but wired - more than wired. I would hike for hours in the midst of this depression just to release energy after having had maybe 4-5 hours of sleep. I scratch myself, beat my head against the floor/wall, howl, and fight. I get completely out of control. and lose touch a bit with reality as I'm so encased in my own agony writhing on the floor clutching my stomach. Mixed state?
I've kicked out a window of my moving car and then opened the door and tried to jump out of it going 60mph just for spite to get away from my then boyfriend driving. THANK GOD, HE GRABBED ME! stuff like this; I could go on and on. I've heard that dysphoric mania is the same as mixed state.
I must say, my lettuce has never talked. That must be a scary place too.I think I'll abstain too. I just want to sort this med thing out. I felt rather good today.
we'll see if it rides out. I hate this unstability. You never know how you'll feel so you can't make that first date arrangement or the job interview, etc.
katia
Posted by Simcha on September 4, 2003, at 1:01:58
In reply to Re: Alcohol Sucks! » BarbaraCat, posted by KimberlyDi on September 2, 2003, at 17:24:51
OK, well, you have had a slip. You have not abandoned the path of recovery. That is what I hear. I hear that you are not in relapse for that would mean denial and you would not be here telling us about it.
I've done 12-step recovery for various addictions for eight years. I've had my slips. For me that has been part of the recovery process. It's progress and not perfection. Slips happen, it's a high statistical probability. The key, for me, is to learn from the slips so that I use less and less.
I have been clean and sober more in the past year and the quality of my recovery is greater still. Eight years has taught me much. One thing is that most of us have slips. The ones who admit it and keep coming back, make it in the long run.
Blessings,
Simcha
> When it comes to alcohol, success can lead to failure. Ironic, isn't it? 10 months sober and enjoying life, made tons of progress, and have everything under control... Hey, I *deserve* a drink. Sure, I had a problem in the past, but I'm *better* now. Over-confidence, thinking the road to recovery is now a speedy 4-lane highway, when in reality, it's a tightrope and always will be one. I think we all long to be normal again. I envy the social drinker.
>
> just my 10 cents worth on the subject
> KDi in Texas
Posted by BarbaraCat on September 4, 2003, at 17:08:14
In reply to talking lettuce » BarbaraCat, posted by katia on September 4, 2003, at 0:42:11
Katia,
Do your tornados correspond with alcohol imbibing? I do not ever get into rages, throwing things, etc., UNLESS I've been seriously drinking. It seems like my rage, which is usually justified but has not been healthfully released, feeds on itself and takes on it's own energy. Alcohol acts like gasoline on a simmering fire, usually towards my husband and prior to that to any man in my life who I felt triggered some deep hurt in me. I would get in touch with a hatred that I either didn't know was there to that intensity, or be able to contain it and work through it - but never completely if the insult was deep enough.I've said some horrible things to my husband. He can certainly get on my nerves in the best of times, but I do love him and normally would never willingly be so cruel. However, there have been times when he's been afraid for his safety. I am an avowed pacifist, a spiritual peaceworker. And I have gotten out of my mind with the urge to wreak havoc upon all living things. I've punched a hole through the wall, etc. But only when I've fanned the flames hot enough with alcohol. It's as though I no longer have conscious control, and sometimes no memory, of this inner insanely rageful furious harpy who I'm sure can take down a city block if she really got going. It really makes me wonder if that rageful demon always waits inside me ready to spring out when the walls are down, if I get invaded and overshadowed by the energy of hate when my protection is weak, who can say. I really don't know if it's my rage or someone or something else's.
My father, however, who never drank, would always turn into a demonic sadistic brutal maniac when his malady struck. His BP manifested in hypomanic swings of multiple projects started and not completed, but more so of a simmering irritability which turned to rage and violence during the extreme mixed states stage, following by intense remorse and black depression. Fun times growing up. His sister was the same way. Mine take on much more of a hallucinogenic (lettuce talk) anguish but that may have something to do with what my neurons learned from my many acid trips.
So, with that, what I've heard is that Depakote is probably the best mood stabilizer for this rageful type of mixed states, not that you're anything like my father was, but once again it's interesting how a subset of an illness has subsets of it's own, and on and on. If you're still enjoying your one glass of dopamine, it would be interesting to chart how you feel before and after and see if it incites any anger for you.
- Barbara
Posted by katia on September 4, 2003, at 21:31:19
In reply to Re: talking lettuce » katia, posted by BarbaraCat on September 4, 2003, at 17:08:14
Hey Barb,
Alcohol has a huge affect on the demon, but the demon has come out many many times without it. Like last summer, I wasn't drinking b/c I was pregnant and I was a maniac. but even prior to the pregnancy and w/o drinking involved I could get pretty hysterical and got into some pretty big fights with ex-d***face. The more I'm reading about Depakote, the more it sounds like it is for me over Li. They say that if you have mixed states and a load of other stuff I have, then Dep. is the better one to take. I realize it's all individual and we'll see if Dep.going to work for me. I took 750mg last night and slept well enough - still had to wake up with the alarm at 10. (even thru' the heavy footed house mate }-(!
I got really tired quickly today, but then I did a lot relatively speaking.
I'm trying to abstain altogether from that g of dopamine. maybe just when I work i'll have one after as the environment's hard to say no. And i only work two nights a week.
well gotta go for now.
Katia
Posted by KimberlyDi on September 5, 2003, at 12:04:37
In reply to Re: talking lettuce » katia, posted by BarbaraCat on September 4, 2003, at 17:08:14
I've had the same problem. My repressed anger runs free when I'm drinking. Strangely enough, I feel cleansed of anger afterwards, yet my husband pays the price. Then the cycle starts again.
KDi in Texas
> Katia,
> Do your tornados correspond with alcohol imbibing? I do not ever get into rages, throwing things, etc., UNLESS I've been seriously drinking. It seems like my rage, which is usually justified but has not been healthfully released, feeds on itself and takes on it's own energy. Alcohol acts like gasoline on a simmering fire, usually towards my husband and prior to that to any man in my life who I felt triggered some deep hurt in me. I would get in touch with a hatred that I either didn't know was there to that intensity, or be able to contain it and work through it - but never completely if the insult was deep enough.
>
> I've said some horrible things to my husband. He can certainly get on my nerves in the best of times, but I do love him and normally would never willingly be so cruel. However, there have been times when he's been afraid for his safety. I am an avowed pacifist, a spiritual peaceworker. And I have gotten out of my mind with the urge to wreak havoc upon all living things. I've punched a hole through the wall, etc. But only when I've fanned the flames hot enough with alcohol. It's as though I no longer have conscious control, and sometimes no memory, of this inner insanely rageful furious harpy who I'm sure can take down a city block if she really got going. It really makes me wonder if that rageful demon always waits inside me ready to spring out when the walls are down, if I get invaded and overshadowed by the energy of hate when my protection is weak, who can say. I really don't know if it's my rage or someone or something else's.
>
> My father, however, who never drank, would always turn into a demonic sadistic brutal maniac when his malady struck. His BP manifested in hypomanic swings of multiple projects started and not completed, but more so of a simmering irritability which turned to rage and violence during the extreme mixed states stage, following by intense remorse and black depression. Fun times growing up. His sister was the same way. Mine take on much more of a hallucinogenic (lettuce talk) anguish but that may have something to do with what my neurons learned from my many acid trips.
>
> So, with that, what I've heard is that Depakote is probably the best mood stabilizer for this rageful type of mixed states, not that you're anything like my father was, but once again it's interesting how a subset of an illness has subsets of it's own, and on and on. If you're still enjoying your one glass of dopamine, it would be interesting to chart how you feel before and after and see if it incites any anger for you.
> - Barbara
Posted by katia on September 5, 2003, at 14:03:26
In reply to Re: Sheesh! I leave for two days...., posted by fluffy on September 3, 2003, at 15:27:21
Hey Katy,
How are you doing on Li?
hope well.
Katia
Posted by fluffy on September 5, 2003, at 14:19:25
In reply to Re: Sheesh! I leave for two days.... » fluffy, posted by katia on September 5, 2003, at 14:03:26
Hey Katia--
Thanks for checking in on me. I was just re-reading some of Barb-cat's posts on Li. I had my first blood test yesterday. I don't know what the results are yet. I see my doc on Tuesday.
I'm actually feeling really, really sleepy the past couple of days. Part of me wonders if it is depression setting in, the other part wonders if it's the Li doing its thing, and perhaps it will pass. I've been clenching my teeth really hard the past couple of days--anxiety, I guess.
Aside from that--I'm feeling a bit sad b/c I think I need to break up with my boyfriend. It's a complicated case--50% of me thinks it's a great relationship, 50% thinks this is all wrong. *sigh* It sucks b/c I really care for him.
Anyway--I hope you are feeling better w/ Depakote. Sounds to me through your posts, that you are feeling better little by little.
Keep in touch, miss Katia,
Katy
Posted by katia on September 5, 2003, at 14:50:18
In reply to Re: Sheesh! I leave for two days...., posted by fluffy on September 5, 2003, at 14:19:25
Hi Miss katy to you,
I am feeling better, but easily exhausted too. It may be a side effect from Depakote 750mg. i take it all at night, but still can't fall asleep for an hour or two. My sleep isn't that great, even tho' I'm tired.
I see my pdoc today; so we'll see. I can't deal with this exhaustion and I am worried about the polycystic ovary thing. Even he wasn't that sure about the real stats on that. No one is at this point. And I would be absolutely devastated if I couldn't have kids one day esp. b/c of all I've been thru' in that dept. already.
I know how you feel about the what to do with current boyfriend dilemma. It could be a reaction to Li or you're mood in general?
I know that I've finally come out the other end of all those dysfunctional fits that felt so good on one level, but were not long lasting or very geniune (not saying that's yours) or communicative and honest and self-aware on both sides. I've done my time I tell you. I can only allow health in my life from now on.
be well,
Katia
p.s. I always use the word "miss" for dogs; like you do here. It's sweet.
Posted by Dr. Bob on September 5, 2003, at 17:45:45
In reply to Re: talking lettuce, posted by KimberlyDi on September 5, 2003, at 12:04:37
> I've had the same problem. My repressed anger runs free when I'm drinking...
Sorry to intrude here, but I'd like to try redirecting this aspect of this thread to the new Psycho-Babble Substance Use board. Here's a link:
http://www.dr-bob.org/babble/subs/20030903/msgs/257391.html
Bob
Posted by katia on September 5, 2003, at 18:58:38
In reply to Re: Sheesh! I leave for two days...., posted by fluffy on September 5, 2003, at 14:19:25
Hi,
Just wanted to say that I just had my session with the doc and because I'm worried about the polycystic thing, we're switching to Lamictal slowlllllly. and then reducing Depakote sllllowly and then finally adding Lithium much later.
He said he'd prefer to have me stay on the Depakote, but since I"m worried about it, it's best to change at this point. I hope I've made the right decision. It's more likely to get the polycytic ovary disease than the Lamictal rash; so what the hell. let's give it a go as I'm quite intrigued by you guys' responses!
feedback?
Katia
Posted by BarbaraCat on September 5, 2003, at 20:40:06
In reply to Lami/Lith combo, posted by katia on September 5, 2003, at 18:58:38
Katia,
I think you know my feelings on lithium/lamictal. It's been the best thing for me by far out of many many many med combos. I've never tried depakote. As you probably know, lamictal can cause agitation if used alone, or when starting out. The fact that you're on depakote should make that less of an issue, but if you start to feel a little activated and its uncomfortable, keep this in mind and ride it out. It usually subsides in 1 week but will probably kick up with each new increase. If you go slow it shouldn't be very noticeable at all. I kind of liked it because it felt sparkly and zippy, but like any good thing, too much of it wasn't a good thing.The chances of your getting the rash are about zip. It seems to hit only those predisposed to it and only when they ramp up too fast. Hopefully your pdoc won't push it past 12.5mg per week, but he sounds like he knows what he's doing. There have been some posters here whose idiot doctors were increasing lam by 50mg a week right from the start. No one got a rash, but they felt pretty awful. Stupid doctors, poor people.
I started getting a response at 25mg, probably the initial activation, then it subsided. Same thing again at 50mg where I stayed for a while cause every time I tried to raise it I got wired, but that was probably all that was going on in my life at the time and I was overboard with stress. Made it to 75mg when 50mg didn't seem to be cutting it anymore and stayed at 75mg for a good 6 months until the bad times around my Mom's death. I'm now at 125mg and that, with 600mg lithium is doing very well. I did try to raise it to 150mg and got real itchy inside and outside my bod so cut back and have been fine since.
Lithium can be slowing which is why I've opted to go with a subtherapeutic level. I don't get any reaction, side effect from lithium at all now, but had slight tremors and lotsa peeing and nausea for a short time in the beginning, but no big deal. Oh, one important thing that your pdoc will surely discuss with you is the necessity for regular thyroid tests. Lithium can interfere with thyroid hormone's action. But this seems to be true more so with those who already have hypothyroid problems (like me for the last 25 years). One piece of hard-won advice - your TSH levels should not go above 3.0 (higher values means lower thyroid hormone activity) no matter what your doc says. Many will say 'oh, as long as it's within range (.9 - 5.0) it's OK'. NOT TRUE! Even slightly above mid-range is considered borderline hypothyroid in many circles and will make you feel lethargic, depressed, cold, fat and miserable. Good luck. Hope it treats you well. - Barbara
> Hi,
> Just wanted to say that I just had my session with the doc and because I'm worried about the polycystic thing, we're switching to Lamictal slowlllllly. and then reducing Depakote sllllowly and then finally adding Lithium much later.
> He said he'd prefer to have me stay on the Depakote, but since I"m worried about it, it's best to change at this point. I hope I've made the right decision. It's more likely to get the polycytic ovary disease than the Lamictal rash; so what the hell. let's give it a go as I'm quite intrigued by you guys' responses!
> feedback?
> Katia
Posted by katia on September 6, 2003, at 0:29:22
In reply to Re: Lami/Lith combo » katia, posted by BarbaraCat on September 5, 2003, at 20:40:06
Hi Barbara,
Do you have a resource re: lithium is good for anti-aging in the brain/axons/dendrites? Wasn't it you who said this? The metabolic guy said that as well. I'd like to read more about this. Who told you?
It looks like maybe our conversation about the glass of dopamine spurred on a new group/substance abuse??? Barb, it's easy! if we ever get redirected, just follow it and we'll converse on different boards.
thanks.
katia
Posted by BarbaraCat on September 6, 2003, at 11:52:56
In reply to Re: Lami/Lith combo » BarbaraCat, posted by katia on September 6, 2003, at 0:29:22
HI Katia,
Here's a good article:www.dbsalliance.org/Research/ResearchUpdate5.html
If you want to do more research, try searching on:
lithium+BDNF
(stands for Brain Derived Neurotrophic Factor)or:
Husseini Manji
who is a doctor who is doing some very cutting edge research on BP and is probably the leader in the field right now. Most of what I've learned on mixed states is from his research.
Two other websites that are probably my favorites on depression/bipolar are:
www.mcmanweb.com
There are links at the top of the page that'll take you big-time into the subject.
Another is:
www.psycheducation.org
This one is a goldmine. There's alot of mixed states info in here, mostly based on Manji's research, but rephrased in easier to understand lingo. Each article has links to other articles. There's an interesting one on PCOS. Also, buried in in one of the article links is a very interesting study on 'dark therapy' as a therapy for rapid cycling. This is interesting because when I'm having a real bad time I'll pull the curtains and shut out the light. I've always thought this was unhealthy cause you need sun and I always thought it was a pathology of depression. But I always felt better after a few days of dark. Turns out it's a good thing and reduces agitated neurochemisty. Anyhow, I've spent hours exploring this site. Both sites keep up to date with new discoveries as well.
About glass(es) of D. Wow! After 5 days of abstaining I feel like a new woman. I kid you not. I'm sleeping without meds, waking up refreshed, feeling clearer, more energy, depression has improved termendously. I still get occasional feelings of doom and anxiety which is when I would turn to my glass(es), but now I've got the trust that it will pass and that alcohol will only make things worse in the long run. It's sooooo nice to wake up not feeling funky and headachey! I'm also not taking valium at all, but still keep it nearby as a security blanket. I'll also continue taking lithium (definitely for the BDNF boost) and lamictal, but feel that my improved brain chemistry will make them work better.
I'll check out the alcohol thread on Social. Thanks for the tip. Could you paste the web address link for one of the posts and I'll join in from there. - Barbara
> Do you have a resource re: lithium is good for anti-aging in the brain/axons/dendrites? Wasn't it you who said this? The metabolic guy said that as well. I'd like to read more about this. Who told you?
> It looks like maybe our conversation about the glass of dopamine spurred on a new group/substance abuse??? Barb, it's easy! if we ever get redirected, just follow it and we'll converse on different boards.
> thanks.
> katia
Posted by katia on September 6, 2003, at 13:09:08
In reply to Redirect: talking lettuce, posted by Dr. Bob on September 5, 2003, at 17:45:45
HI Barb,
Here is the link and if it doesn't appear on this post; just go to the redirect one from Dr. Bob down below and click on it.
Thanks for the lithium info. I'll be sure to research it.
I'm sending you a post over at substance board; so be sure to pick it up!
Katia
Posted by fluffy on September 6, 2003, at 15:09:58
In reply to Re: Redirect: talking lettuceBarbara, posted by katia on September 6, 2003, at 13:09:08
Hi you guys--
I'm feeling bad again. I feel like I've been conked over the head. SOOOOO sleepy and weepy. I cried and cried yesterday, and choked down food b/c I wasn't hungry. I wanted to break up with my boyfriend. My teeth have been clenched HARD for a couple of days. But I'm able to think more clearly (if that makes sense). But I'm feeling negative and a bit irritable. The only way I can relax and sleep at night is by taking a benzo. I can feel my teeth unclench, and slowly I drift into sleep.
Honestly, I don't really understand what's going on with my mood. Feels a bit like PMS. BUT SLEEPY! I can't tell if its a medication feeling, or if I'm have "symptoms" of BP.
What's my point? I don't know. I just don't want to wear my friends out with my misery. (see--I can't follow my own advice!)
I know you guys will understand.
Katy
Posted by katia on September 6, 2003, at 15:48:46
In reply to Re: I feel bad..., posted by fluffy on September 6, 2003, at 15:09:58
Hi Miss Katy,
So sorry you're feeling badly. And I have noticed that you disappear from the board when you're in a bad way and show up more when you're in a good way. You're not wearing me out, I always miss you when you leave for a few days. That's what we're here for.Have you called your pdoc? I know that I went haywire on Depakote for the titration up to therapeutic dose and I told my pdoc about it. He said that actually has happened to a few other BP people and it's part of the titration. It could be what you're experiencing now (except with Li). You may just need time and the right dose before Li. kicks in. Your upness/anxiety may be from the Lamictal and the Li. hasn't activated yet?
Maybe call your doctor? This is really tough. It always feels like it's changing; nothing feels for certain. I understand.
big hug,
Katia
> Hi you guys--
>
> I'm feeling bad again. I feel like I've been conked over the head. SOOOOO sleepy and weepy. I cried and cried yesterday, and choked down food b/c I wasn't hungry. I wanted to break up with my boyfriend. My teeth have been clenched HARD for a couple of days. But I'm able to think more clearly (if that makes sense). But I'm feeling negative and a bit irritable. The only way I can relax and sleep at night is by taking a benzo. I can feel my teeth unclench, and slowly I drift into sleep.
>
> Honestly, I don't really understand what's going on with my mood. Feels a bit like PMS. BUT SLEEPY! I can't tell if its a medication feeling, or if I'm have "symptoms" of BP.
>
> What's my point? I don't know. I just don't want to wear my friends out with my misery. (see--I can't follow my own advice!)
>
> I know you guys will understand.
>
> Katy
Posted by katia on September 6, 2003, at 16:02:25
In reply to Re: Lami/Lith combo » katia, posted by BarbaraCat on September 6, 2003, at 11:52:56
Hey Barb,
I checked out that website. and it looks like Lithium AND Depakote has these anti-aging qualities to them???? I wonder if I'm doing the right thing by coming off of Dep. I just don't like that polycyctic thing....
And I won't be coming off of it right away. Not even for four more weeks will I begin titrating downwards. I start Lamictal at 5mg and titrating up 5mg every two weeks. With the titrating schedule, I"ll be on Depa. for another 8 weeks! He's doing it very slowly. I think (I think) he's doing it b/c he wants to be safe (one) and (two) b/c he wants to see what Dep. will do for me while also appeasing me. I don't even get to 10mg of Lam. until three weeks from now! At week 8, i'll be at 50mg! I think he's being clever. He also says that depending on how I do on Depakote, he will be able to tell a lot about dxing and treatment plans to follow, regardless if we stay on Dep. I almost feel like I've taken the matter into my own hands and he's letting me in a way, but also being clever enough to experiment for awhile, possibly for my own good.
that's my take on it.
and btw, I have another crush on him!!! What's this about? I get nervous and giggly. I know this is something not about him, but transference related. But what if I geniunely have a crush on him without any transference issues? I know I know, redirect to social. if we talk anymore about it, just follow the link.
Katia
Posted by BarbaraCat on September 6, 2003, at 16:23:02
In reply to Re: I feel bad..., posted by fluffy on September 6, 2003, at 15:09:58
Oh booo and poo to those yucky feelings! Don't forget about Li making you tired at first. It goes away. You're taking Lamictal, right? Well, lithium is going to potentiate the lamictal and make each stronger. You may be getting that dose increase feeling. Everytime I went up with lamictal I felt unsettled. In fact, whatever you're on, the lithium is going to boost it's effects - it's known as 'the first-line augmentor', don't forget! Like a med turbo-charger - that's surely been my experience.
So hang in there and try not to feel bad because you're feeling bad and don't get scared because it's rough right now. It's to be expected while your chemistry is adjusting - up and down and all around. But you'll get through it soon. Praying and journaling helped me alot during my dark days. Journaling for me is better than talking to my therapist, but definitely talk to your pdoc and see if there's something short-term to get you through this blip. Some have said Zyprexa or pindolol helps. Just try not to drink during this time (whooo, you wanna REALLY feel bad?!) and you're warmly invited to join Katia and me in the Hopefully Abstaining Babblers Society (we sure would love your company and support). And who knows, maybe it IS pms! Luv and hugs, Barbara
> I'm feeling bad again. I feel like I've been conked over the head. SOOOOO sleepy and weepy. I cried and cried yesterday, and choked down food b/c I wasn't hungry. I wanted to break up with my boyfriend. My teeth have been clenched HARD for a couple of days. But I'm able to think more clearly (if that makes sense). But I'm feeling negative and a bit irritable. The only way I can relax and sleep at night is by taking a benzo. I can feel my teeth unclench, and slowly I drift into sleep.
>
> Honestly, I don't really understand what's going on with my mood. Feels a bit like PMS. BUT SLEEPY! I can't tell if its a medication feeling, or if I'm have "symptoms" of BP.
>
> What's my point? I don't know. I just don't want to wear my friends out with my misery. (see--I can't follow my own advice!)
>
> I know you guys will understand.
>
> Katy
Posted by fluffy on September 6, 2003, at 17:17:35
In reply to Re: I feel bad... » fluffy, posted by BarbaraCat on September 6, 2003, at 16:23:02
Hi Barb-cat--
Interesting take on my situation (the Li boosting the effects of Lam). Funny--I was thinking to myself--uuuuggg!--this is EXACTLY how I felt when I titrated up on my Lamictal dose--sleepy, wired, and a weird feeling of being unable to yawn--Is that hyperventillation?? And I AM about to start my period. So maybe it's a whole host of nasty things piling on top of one another. Just please, god, let me get through the class I have to teach this Tuesday, and the opening of an art exhibition I'm in. That's all I ask. Just those two things, and I'll be happy.
A wonderful friend of mine who's bipolar I told me last night (re: my irritation with my boyfriend). "You have your dark glasses on--I can tell. DO NOT make any big decisions feeling the way you do." Very good advice. Esp. considering that my BF is the only one who seems to have mercy on me when I feel bad.
Yes--I'm obviously still cycling!! I can tell from my posts. I hate that.
I see my doc this tuesday. I'll tell him what's happening.
Thanks for the encouragement. Hugs to you guys,
Katy
Posted by BarbaraCat on September 6, 2003, at 17:45:40
In reply to Re: I feel bad..., posted by fluffy on September 6, 2003, at 17:17:35
>>--sleepy, wired, and a weird feeling of being unable to yawn--Is that hyperventillation??
**Funny you should ask. There is a thing called Hyperventilation Syndrome and it causes anxiety, depression, fatigue. It's when, from whatever reason, the Oxygen/CO2 balance is off and Ox is too high and CO2 too low which causes a screwup in intercellular calcium and blood pH. There are a couple books I've read on it because one of my main symptoms when I'm bouncing off the walls is not being able to take a full breath, and then I'll sigh alot. In fact, I do this alot no matter how I'm feeling because my tendency is to hold my breath in when I'm concentrating on something. Now, I've done yoga for years and I know breathing, but I was missing something until I found it described in the books!
Here's how to retrain things:
1. Slowly inhale from the nose from the lower lung area, front and back.
2. Slowly exhale from the nose completely and when you get to the end of the exhale
3. Pinch your nose to retain the air, but try not to tighten around it, just hold the air in for as long as you can. Count how many seconds you can hold it.
4. When you feel like you're going to burst, let the air back in, but do not gasp or gulp the air in, even though you'll want to. As slowly as possible, inhale through the nose (but don't torture yourself) otherwise the gasping/sighing in a big inhale will defeat the purpose.
5. Wait 5 minutes and then do it again. Wait another 5 minutes and do it again.
6. Practice this cycle once a day, gradually increasing the retention time.You'll probably start being able to retain your breath for less than 10 seconds. You're supposed to work up to around 30 seconds while sitting, and then work up to 30 seconds while walking. This is supposed to retrain the breathing reflex and rebalance the pH balance and OX/CO2 ratio. I haven't done it enough to say 'wow, it really works' because I don't remember it when I need it, but when I've done it I've been able to breathe normally, feel less anxious, and it even clears my sinuses. Worth giving a try for a while. I'm going to start doing it again. Wouldn't it be funny if something so simple could help alot?
Anyhow, don't lose the BF. Good luck with your show. Do this breathing retention before and it should really help with the anxiety (as long as you don't pass out - just kidding). - Barbara
Posted by BarbaraCat on September 6, 2003, at 18:06:27
In reply to Re: Lami/Lith combo » BarbaraCat, posted by katia on September 6, 2003, at 16:02:25
It sounds like your doctor is going about things with good sense. You never know what might happen when you add the lamictal. It might be just the spark depakote needs. Lithium sure didn't do it for me alone, but when I added the lamictal I felt a difference in a very short time.
Lithium and Dep both have that BDNF quality, but from other things I've read, lithium has other beneficial qualities as far as the ionic gates that Dep doesn't have. Don't ask me where I saw this, one of my surfing meanderings. Things change so quickly with the science, though, you should explore this further and let me know what you find out.
With lithium you have the thyroid problem. With Depakote the weight gain and PCOS. Take your pick.
I think this crush thing happens all the time and it's not necessarily transference. Hey, you got a nice guy who'se paying attention and cares about you, is smart and educated - good looking and funny is a bonus. What's to wonder? There aren't that many potential love interests who have all those qualities. You'll probably go 'EEEEK!' but consider talking about it with him. If you're acting blushy and giggly, he probably knows, and it would be good to get it out on the table (or HIM on the table - heh, heh. Oh no, did I say that?!). That's my two cents so Dr. Bob doesn't have to redirect us. Plus, we discussed meds plenty to make up for it. - Barbara
Posted by fluffy on September 6, 2003, at 18:14:14
In reply to Re: I feel bad... » fluffy, posted by BarbaraCat on September 6, 2003, at 17:45:40
That's interesting info, Barbara. I wonder what the hyperventilation stuff has to do with psych meds? When I go to my doc, he asks me a host of questions about side effects. One of them is: Are you sighing or hyperventilating?
Either way--I've always sighed constantly. It weirds people out. They wonder if I'm impatient or pissed. I'm usually not--just relieving myself.
I'm gonna try it. Can't hurt. I think it's funny advice to NOT BREATHE. When you're upset, people are always saying--"just breathe--take deep breaths." Yoga has never helped me with breathing.
Thanks!
Katy
Posted by BarbaraCat on September 7, 2003, at 0:16:37
In reply to thanks for the breathing advice!, posted by fluffy on September 6, 2003, at 18:14:14
I don't know why your doctor would ask you about sighing except for it may indicate depression. Maybe western medicine is hip to 'disordered breathing', a big contributor to mental imbalance, according to some yoga texts. In fact, some say that disordered breathing is the MAJOR contributor to mental imbalance. The texts go on to talk about irregular breathing, sighing, ragged in and outs, as severely imbalancing the nervous system. But most of what you hear about yogic breathing is the deep belly breathing stuff - take a deep breath. It's never done anything for me either and I've always felt that I didn't know how to do it right, even though I've been 'trying' to do it right for a long time. According to the info I read, the big inhale/oxygen saturation we're taught is proper deep breathing disrupts the pH and can bring on panic attacks and asthma symptoms. The reason we're told to breathe into a paper bag during a panic attack is to increase the carbon dioxide in the blood and bring the pH back to normal levels. Carbon dioxide is a good thing, despite what we're told about how bad it is and how good oxygen is. Surprised me. I guess we need the balance.
So now I've been paying more attention to breathing since hearing about this hyperventillation syndrome. I don't always get it right and sometimes feel like my diaphragm is locked up. But what's supposed to work for normal breathing to relax (not the holding the nose exercise which is more of a therapeutic workout and retraining) is to make the exhale about twice as long as the inhale and use the stomach muscles to wring out that last bit of air, but without forcing anything - just a kind of relaxed squeezing it out. Don't have to be anal with the count either. The idea is that you want to focus on the exhale and squeeze out as much of the stale air as possible, pause for a second or so, and then you don't have to even think about the inhale. It happens by itself and with the right amount of air just by releasing the abdomen after the exhale and short pause. It really is relaxing and clears the head. Plus you get a bonus ab workout.
The breathing is normally done through the nose, but a variation on it that I like alot is to put your tongue against your teeth and exhale from the mouth making a 'sssssss' sound like a steam kettle. Use a bit of resistance, in other words, don't let the air whoosh out too quickly, but make the exhale long and slow keeping the hissy sound even. Or you could purse your lips like you're blowing out a candle, again with a little resistance so that it doesn't come out too fast. Super relaxing, clearing, and gets you pleasantly high in a nice way! You can't expect to breathe like this all the time, but whenever you have a little time, like waiting in lines, at a stop light, or even devoting some time on a regular basis in the morning and eve, it will be a nice break.
I think it will help you, Katy, especially if you sigh alot. That sounds like a sure case of 'disordered breathing' to me that the yogi's speak of - having been there and done that myself. - Barbara
> That's interesting info, Barbara. I wonder what the hyperventilation stuff has to do with psych meds? When I go to my doc, he asks me a host of questions about side effects. One of them is: Are you sighing or hyperventilating?
>
> Either way--I've always sighed constantly. It weirds people out. They wonder if I'm impatient or pissed. I'm usually not--just relieving myself.
>
> I'm gonna try it. Can't hurt. I think it's funny advice to NOT BREATHE. When you're upset, people are always saying--"just breathe--take deep breaths." Yoga has never helped me with breathing.
>
> Thanks!
> Katy
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